The Tacit Bargain in Short-Term Medical Missions: Why US Physicians Go and What It Costs

Paul Henry Caldron, UNU-MERIT / School of Governance

Short-term medical missions (STMMs) refers to the activity whereby physicians who are gainfully engaged in medical or surgical practice in their home countries spend short periods away in lower and middle income countries (LMICs), without pay, to provide services directly to the ostensibly poor. Such “missions” are planned and represent a highly direct expression of transnational aid in a novel format that is unregulated by any bureaucracy. The dimensions of the activity worldwide have not been well characterised. This dissertation used combined methodologies of systematic literature review, an online survey of physicians, and interviews with physicians to explore the motivating factors for physicians who participate in STMMs from the US and to estimate the economic and manpower inputs. The results provide insight into a partial profile of participating physicians, and indicate that motivation is driven by the sense of satisfaction from helping, using their medical and surgical skills, influenced by a blend of attributes, attitudes, and feedback. The numbers of STMMs and participation rate by US physicians appears to be growing, and the expenditures are material when benchmarked against US federal foreign aid outlays.